International journal of radiation oncology, biology, physics, 2012, Vol.82 (1), p.204-212
2012
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- Autor(en) / Beteiligte
- Titel
- Comparison of Acute and Late Toxicities for Three Modern High-Dose Radiation Treatment Techniques for Localized Prostate Cancer
- Ist Teil von
- International journal of radiation oncology, biology, physics, 2012, Vol.82 (1), p.204-212
- Ort / Verlag
- New York, NY: Elsevier Inc
- Erscheinungsjahr
- 2012
- Quelle
- MEDLINE
- Beschreibungen/Notizen
- Purpose We compared acute and late genitourinary (GU) and gastrointestinal (GI) toxicities in prostate cancer patients treated with three different high-dose radiation techniques. Methods and Materials A total of 1,903 patients with localized prostate cancer were treated with definitive RT at William Beaumont Hospital from 1992 to 2006: 22% with brachytherapy alone (BT), 55% with image-guided external beam (EB-IGRT), and 23% external beam with high-dose-rate brachytherapy boost (EBRT+HDR). Median dose with BT was 120 Gy for LDR and 38 Gy for HDR (9.5 Gy × 4). Median dose with EB-IGRT was 75.6 Gy (PTV) to prostate with or without seminal vesicles. For EBRT+HDR, the pelvis was treated to 46 Gy with an additional 19 Gy (9.5 Gy × 2) delivered via HDR. GI and GU toxicity was evaluated utilizing the NCI-CTC criteria (v.3.0). Median follow-up was 4.8 years. Results The incidences of any acute ≥ Grade 2 GI or GU toxicities were 35%, 49%, and 55% for BT, EB-IGRT, and EBRT+HDR ( p < 0.001). Any late GU toxicities ≥ Grade 2 were present in 22%, 21%, and 28% for BT, EB-IGRT, and EBRT+HDR ( p = 0.01), respectively. Patients receiving EBRT+HDR had a higher incidence of urethral stricture and retention, whereas dysuria was most common in patients receiving BT. Any Grade ≥2 late GI toxicities were 2%, 20%, and 9% for BT, EB-IGRT, and EBRT+HDR ( p < 0.001). Differences were most pronounced for rectal bleeding, with 3-year rates of 0.9%, 20%, and 6% ( p < 0.001) for BT, EB-IGRT, and EBRT+HDR respectively. Conclusions Each of the three modern high-dose radiation techniques for localized prostate cancer offers a different toxicity profile. These data can help patients and physicians to make informed decisions regarding radiotherapy for prostate andenocarcinoma.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0360-3016eISSN: 1879-355XDOI: 10.1016/j.ijrobp.2010.10.009Titel-ID: cdi_osti_scitechconnect_22055935
- Format
- –
- Schlagworte
- Acute Disease, Adenocarcinoma - pathology, Adenocarcinoma - radiotherapy, Adult, Aged, Aged, 80 and over, BEAMS, Biological and medical sciences, Bleeding, BRACHYTHERAPY, Brachytherapy - adverse effects, Brachytherapy - methods, COMPARATIVE EVALUATIONS, Data processing, Decision making, DOSE RATES, External beam, Follow-Up Studies, Gastrointestinal Hemorrhage - etiology, Gastrointestinal Tract - radiation effects, Gynecology. Andrology. Obstetrics, Hematology, Oncology and Palliative Medicine, Hospitals, Humans, Male, Male genital diseases, Medical sciences, Middle Aged, NEOPLASMS, Nephrology. Urinary tract diseases, Organs at Risk - radiation effects, PATIENTS, PELVIS, Proctitis - etiology, PROSTATE, Prostate - radiation effects, Prostate cancer, Prostatic Neoplasms - pathology, Prostatic Neoplasms - radiotherapy, Quality of life, RADIATION DOSES, Radiation Injuries - complications, Radiation toxicity, Radiology, RADIOLOGY AND NUCLEAR MEDICINE, Radiotherapy, Radiotherapy Dosage, Radiotherapy, Image-Guided - adverse effects, Radiotherapy, Image-Guided - methods, Radiotherapy, Intensity-Modulated - adverse effects, Radiotherapy, Intensity-Modulated - methods, RECTUM, Rectum - radiation effects, Seminal vesicle, Seminal Vesicles - radiation effects, STANDARD OF LIVING, Stenosis, TOXICITY, Tumors, Tumors of the urinary system, Urethra - radiation effects, Urethral Stricture - etiology, Urinary Bladder - radiation effects, Urinary Retention - etiology, Urinary tract. Prostate gland, Urogenital System - radiation effects